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Am pregnant. Ultrasound showed big baby. Should I be concerned about the rise in SD?

May 2013
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Practicing since : 2006
Answered : 4909 Questions
Hello. I am currently pregnant and have a question. My last child was stillborn at 39 weeks gestation after an uncomplicated pregnancy. Birth weight was 9 pounds 3oz. Tests revealed placental insuffficiency. During my current pregnancy, I have been closely monitored. I had an ultrasound scan at 27 weeks and the SD ratio was 2.3 with bubs expected weight 1270grams (always have big babies). I have just had another scan at 32 weeks gestation and the estimated weight of bubs is now 2560 grams but the SD has RISEN to 3. Our specialist is wonderful and was not worried as the SD is within normal limits. From what I have read though the SD should be going down at this stage of pregnancy not going up. Should I be concerned that the SD has risen from 2.3 to 3 in the last five weeks (scans at 27 weeks and 32 weeks) and when would you recommend a repeat scan? I am 32 weeks pregnant. Thank you.
Posted Wed, 5 Sep 2012 in Pregnancy
Answered by Dr. Sree Gouri SR 1 hour later
Thanks for the query.

though S/D ratio up to 3.5 is considered normal in pregnancy, usually with progression of pregnancy the ratio should decrease as there will be increased diastolic blood flow, and after 30 weeks the ratio is found be less than 3 in normal pregnancies usually,
anyhow it is good that at present your baby growth is normal and you are not having any features like gestational hypertension etc,
but increased S/D ratio can lead to future complications like fetal distress in labor, meconium passage during delivery, increased chance of cesarean section etc,
as you are also having prior history of still birth, you have to be more cautious,
with your doctor's advice you can follow measures like,
-daily fetal movement count- for 1 hour at the same time every day after activity like walking, 10 movements per one hour are noted usually.
-prefer lying in left lateral position,
-regular antenatal checkups, nutritious diet and regular medicines,
-preferably weekly twice or at least once non stress test to know the well being of the baby,
-weekly once biophysical profile monitoring with ultrasound,
-S/D ratio can be checked after 2 weeks, but if any abnormality noted in above parameters better to check at the same sitting.

with these measures you can detect any abnormality in fetal well being early and necessary treatment can be taken immediately.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.
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